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Chapter 34 – Medoroga Nidanam

The Chapter 34 of Madhava Nidana is Medoroga nidanam which deals with Obesity.

Etiopathogenesis —

अव्यायाम – दिवास्वप्न – श्लेष्मलाहारसेविनः |
मधुरो अन्नरसः प्रायः स्नेहान्मेदः प्रवर्धयेत् || १ ||
मेदसा आवृत मार्गत्वात् पुष्यन्त्यन्ये न धातवः | 

avyāyāma – divāsvapna – ślēṣmalāhārasēvinaḥ |
madhurō annarasaḥ prāyaḥ snēhānmēdaḥ pravardhayēt || 1 ||
mēdasā āvr̥ta mārgatvāt puṣyantyanyē na dhātavaḥ |

Clinical Features —

मेदस्तु चीयते तस्मादशक्तः सर्वकर्मसु ||२ ||
क्षुद्रश्वास – तृषा – मोह – स्वप्न – क्रथन – सादनैः |
युक्तः क्षुत्स्वेद – दौर्गन्ध्यैरल्पप्राणो अल्पमैथुनः || ३ ||
मेदस्तु सर्वभूतानामुदरेष्वस्थिषु स्थितम् |
अत एवोदरे वृद्धिः प्रायो मेदस्विनो भवेत् || ४ ||
mēdastu cīyatē tasmādaśaktaḥ sarvakarmasu ||2 ||
kṣudraśvāsa – tr̥ṣā – mōha – svapna – krathana – sādanaiḥ |
yuktaḥ kṣutsvēda – daurgandhyairalpaprāṇō alpamaithunaḥ || 3 ||
mēdastu sarvabhūtānāmudarēṣvasthiṣu sthitam |
ata ēvōdarē vr̥ddhiḥ prāyō mēdasvinō bhavēt || 4 ||

Sequelae and complications —

मेदसा आवृतमार्गत्वाद्वायुः कोष्टे विशेषतः |
चरन् सन्धुक्षयत्यग्निमाहारं शोषयत्यपि || ५ ||
तस्मात् स शीघ्रं जरयत्याहारमभिकाङ्क्षति |
विकारांश्चाप्नुते घोरान् कांश्चित् कालव्यतिक्रमात् || ६ ||
एतावुपद्रवकरौ विशेषदग्निमारुतौ |
एतौ तु दहतः स्थूलं वनदावो वनं यथा || ७||
mēdasā āvr̥tamārgatvādvāyuḥ kōṣṭē viśēṣataḥ |
caran sandhukṣayatyagnimāhāraṁ śōṣayatyapi || 5 ||
tasmāt sa śīghraṁ jarayatyāhāramabhikāṅkṣati |
vikārānścāpnutē ghōrān kānścit kālavyatikramāt || 6 ||
ētāvupadravakarau viśēṣadagnimārutau |
ētau tu dahataḥ sthūlaṁ vanadāvō vanaṁ yathā || 7||

Prognosis —

मेदस्यतीव संवृद्धे सहसैवानिलादयः |
विकारान् दारुणान् कृत्वा नाशयन्त्याशु जीवितम् || ८ || 

mēdasyatīva samvr̥ddhē sahasaivānilādayaḥ |
vikārān dāruṇān kr̥tvā nāśayantyāśu jīvitam || 8 ||

Causes for increase in fat and kapha (medas) include the following:

  • Absence of physical activity,
  • Sleeping during day and the like.

The intake of eatables in large quantity makes the product of digestion to become sweet. This obstructs the nutrient channels of the remaining tissues depriving them of nutrition. So a large quantities of fat accumulate in the body. This in turn, makes the person incapable of all activities.

  • Difficulty in breathing even on slight exertion,
  • Thirst
  • Delusion
  • Sleep
  • Sudden catching of breath,
  • Exhaustion,
  • Excessive hunger,
  • Bad smell of the body and
  • Poor physical and sexual capacity gradually develop.

As the stomach and bones are the chief depots of fat, the stomach gets enlarged in such persons. The channels of Vata become obstructed by the increase in fat inside the stomach; Vata then begins to act fast inside the stomach. It promotes digestive activity, making room for a voracious hunger and craving for large amount of eatables.

In course of time, several features that are more distressing develop. Gastric fire (agni) and Vata acting together are very harmful. Just as the forest fire destroys the forest, these destroy the body. The three doshas get increased, cause several and severe implications. There is even quick loss of life with increase in fat. 1-8

इति श्रीमाधवकरविरचिते माधवनिदाने मेदोरोगनिदानं समाप्तम् || ३४ ||

iti śrīmādhavakaraviracitē mādhavanidānē mēdōrōganidānaṁ samāptam || 34 ||

Thus concludes the chapter on Medo roga.